1. Stakeholder Involvement Dunadry Hotel 21 st November 2007

2. Stakeholder Involvement Workshop Sean Donaghy Director of Finance and Corporate Services (Designate) Health and Social Care Authority

3. Objectives for workshop To provide an update on progress since the last workshop in June To provide an update on progress since the last workshop in June To quality assure and comment on the final draft of the Stakeholder Involvement Framework document To quality assure and comment on the final draft of the Stakeholder Involvement Framework document To seek a network response to Programme for Government, and to inform 2009/10 Health and Social Care priorities To seek a network response to Programme for Government, and to inform 2009/10 Health and Social Care priorities –Through focussing today on a single key theme

4. Why a Stakeholder Involvement Network? Demonstration of commitment to engagement Demonstration of commitment to engagement Enable views to be gathered in relation to relevant matters Enable views to be gathered in relation to relevant matters Establish good practice in relation to engagement and partnership Establish good practice in relation to engagement and partnership Create a resource for network participants and for those involved in policy development, commissioning and planning. Create a resource for network participants and for those involved in policy development, commissioning and planning.

5. Recap from 21 st June workshop broad support and enthusiasm for a regional network. broad support and enthusiasm for a regional network. Network could add value by: systematic sharing of information and practice and systematic sharing of information and practice and securing resolved views and advice from a diverse stakeholder group on regional challenges and opportunities to improve health and wellbeing. securing resolved views and advice from a diverse stakeholder group on regional challenges and opportunities to improve health and wellbeing.

6. The network, has the potential to be an effective influencer; we will look to it to reflect the views and aspirations of stakeholders, so that Government priorities are rooted in the experience of users and stakeholders. Andrew Hamilton, June 2007

7. Where are we now? Framework document Framework document –Discussion over past two months –Positioning the network on a crowded pitch –Local Commissioning Group role –Trust role Virtual network for e-communication Virtual network for e-communication –website in design and development stage –discussion forum

8. Other issues in progress Public Attitude Survey, follow up – qualitative work Public Attitude Survey, follow up – qualitative work Patient opinion Patient opinion Guidelines for commissioners (CDHN) Guidelines for commissioners (CDHN) Benefits realisation plan Benefits realisation plan Series of workshops on general and specific issues Series of workshops on general and specific issues Mapping exercise Mapping exercise RCGP RCGP

9. Programme Welcome back Welcome back Update and progress since June workshop Update and progress since June workshop Outline for today Outline for today Session 1 – Draft Framework Document Session 1 – Draft Framework Document Break Break Session 2 – Informing Policy Session 2 – Informing Policy –Overview of policy and planning Cycle –Independent living theme Direct payments Direct payments Tele-Health Tele-Health Supported Housing Supported Housing

10. Sharon Henry Project Director Stakeholder Involvement Modernisation Directorate

11. Process Ongoing discussion over past two months Ongoing discussion over past two months Useful discussion and comment at formative stage Useful discussion and comment at formative stage These have been/will be incorporated into document These have been/will be incorporated into document

12. Draft Framework Aim To create a process that brings together stakeholders to work collectively to improve health and wellbeing in Northern Ireland by facilitating the exchange of knowledge, ideas and information to inform and influence policy and actions through an open participative regional network. To create a process that brings together stakeholders to work collectively to improve health and wellbeing in Northern Ireland by facilitating the exchange of knowledge, ideas and information to inform and influence policy and actions through an open participative regional network.

13. Objectives To develop a network of stakeholders in Northern Ireland linked to existing networks in order to create a regional system which adds value to all who participate. To develop a network of stakeholders in Northern Ireland linked to existing networks in order to create a regional system which adds value to all who participate. Develop mechanisms that enable the network to identify and prioritise regional themes which can contribute to Programme for Government and Priorities for Action Develop mechanisms that enable the network to identify and prioritise regional themes which can contribute to Programme for Government and Priorities for Action To become an effective influencer in strategic decisions making and priorities, through informed collective responses. To become an effective influencer in strategic decisions making and priorities, through informed collective responses.

14. DEPARTMENT POLICIES DEPARTMENT POLICIES BALANCEBALANCE BALANCEBALANCE LOCAL STAKEHOLDER INVOLVEMENT LOCAL STAKEHOLDER INVOLVEMENT PROGRAMME FOR GOVERNMENT PROGRAMME FOR GOVERNMENT Northern Ireland ASSEMBLY Northern Ireland ASSEMBLY HSC TRUSTS BELFAST SOUTHERN SOUTH EASTERN NORTHERN WESTERN Ambulance Trust LCGs IfH HSC TRUSTS BELFAST SOUTHERN SOUTH EASTERN NORTHERN WESTERN Ambulance Trust LCGs IfH SERVICEUSERSSERVICEUSERS SERVICEUSERSSERVICEUSERS BOARDS/ HSCA BOARDS/ HSCA MEASURING & EVALUATING IMPACT Northern Ireland STAKEHOLDER INVOLVEMENT NETWORK Northern Ireland STAKEHOLDER INVOLVEMENT NETWORK COMMUNITIES OF INTEREST THE ARTICULATE VOICE COMMUNITIES OF INTEREST THE ARTICULATE VOICE STAKEHOLDER INVOLVEMENT IN NORTHERN IRELAND Informing Policy – Improving Implementation STAKEHOLDER INVOLVEMENT IN NORTHERN IRELAND Informing Policy – Improving Implementation &WELLBEING&WELLBEING POPULATIONHEALTHPOPULATIONHEALTH The Network Formal Management Arrangements OTHER NGOs & STATUTORY ORGANISATIONS COMMUNITY & VOLUNTARY ORGANISATIONS OTHER NGOs & STATUTORY ORGANISATIONS COMMUNITY & VOLUNTARY ORGANISATIONS

15. Questions for Discussion 1. Does the Framework document clearly define the purpose of this network? (Section 4) 2. Does the Framework document clarify how this network links with, but is distinct from, other Stakeholder Involvement processes in HSC? (Section 5) (Section 5)

16. Questions (cont …) 3. Does the Framework document demonstrate the added value/benefits participants will get from contributing to the network? (Sections 6 & 7) 4. Any other comments/questions in relation to the document

17. Overview of Policy and Planning Cycle Sean Donaghy

18. Overview of Policy and Planning Cycle

19. Theme for informing response to Programme for Government and 2009/10 Priorities Independent Living Health and Social Care strategies and policy Draft Programme for Government Why hasnt it happened already, how can we move from policy to practice?

20. Direct payments Health and Social Care introduced schemes to allow individuals to control funds to meet their care needs over 15 years ago Health and Social Care introduced schemes to allow individuals to control funds to meet their care needs over 15 years ago Very low levels of take-up Very low levels of take-up Vela Micro Boards in Southern area Vela Micro Boards in Southern area Potential for enhancing choice and moving to truly person-centred planning Potential for enhancing choice and moving to truly person-centred planning What about 1,000s of people with Chronic Disease, Older People, in addition to current limited progress in Physical and Learning Disability? What about 1,000s of people with Chronic Disease, Older People, in addition to current limited progress in Physical and Learning Disability? How do we move to personal choice as the core approach? How do we move to personal choice as the core approach?

21. Anne Lynch Regional Director of Commissioning (Designate) Health and Social Care Authority

22. Tele - Health

23. What is Tele-Health? At its broadest definition…..conducting therapeutic health and/or care interactions between patients/clients and health and care professionals by supplementing any face to face contact with technological links At its broadest definition…..conducting therapeutic health and/or care interactions between patients/clients and health and care professionals by supplementing any face to face contact with technological links Sometimes tele-health, tele-care, tele- diagnostics, tele-monitoring used almost interchangeably Sometimes tele-health, tele-care, tele- diagnostics, tele-monitoring used almost interchangeably

24. What is Tele-Monitoring? A number of people stay at home independently A number of people stay at home independently Linked electronically to a central nurse led service Linked electronically to a central nurse led service Vital signs transmitted daily by patients/clients to nursing station Vital signs transmitted daily by patients/clients to nursing station

25. The Imperative Demography – working age population to grow by 8% by 2019 Demography – working age population to grow by 8% by 2019 Over 65 years population to grow by 35% by 2019 Over 65 years population to grow by 35% by 2019 More single person households More single person households Chronic diseases will increase Chronic diseases will increase Many people currently in and out of hospital frequently when they could be supported more appropriately elsewhere Many people currently in and out of hospital frequently when they could be supported more appropriately elsewhere

26. Chronic Diseases Heart Failure Heart Failure Respiratory diseases Respiratory diseases Diabetes Diabetes Stroke Stroke Physical Disability Physical Disability Cancer Cancer

27. Who could benefit? Patient selection is key Patient selection is key Used in conjunction with traditional home care Used in conjunction with traditional home care Provided 7 days a week Provided 7 days a week Customised reports sent to GPs etc. Customised reports sent to GPs etc.

28. What is needed at home? The electronic kit as shown The electronic kit as shown Working phone line Working phone line Home is safe for the equipment Home is safe for the equipment Person can perform monitoring by 12 noon Person can perform monitoring by 12 noon

29. Equipment in the patients home

30. How does it work on a daily basis? Patient/client uses his/her home based technology to monitor vital signs Patient/client uses his/her home based technology to monitor vital signs Device also asks disease specific questions Device also asks disease specific questions Patient transmits information to central Nursing Station Patient transmits information to central Nursing Station Nurse monitors information and evaluates anything outside normal parameters Nurse monitors information and evaluates anything outside normal parameters Nurse contacts patient, District Nurse, GP etc as appropriate Nurse contacts patient, District Nurse, GP etc as appropriate

31. Dashboard: shows daily readings of patient specific information

32. Benefits Supports people in their own homes Supports people in their own homes Reduces hospital acquired infection risk Reduces hospital acquired infection risk Develops expert patients Develops expert patients Health improvement benefits for the family circle Health improvement benefits for the family circle Potential for community capacity development Potential for community capacity development

33. Decreases frequency of nursing visits but makes them more appropriate and targeted Decreases frequency of nursing visits but makes them more appropriate and targeted Specialist nurses/others can be sent to homes where necessary Specialist nurses/others can be sent to homes where necessary Better planning for the case load of people in a local area Better planning for the case load of people in a local area

34. Promoting Independence by Supported Housing

35. Basic Assumptions People would prefer to live in their own home for as long as possible People would prefer to live in their own home for as long as possible In principle, people should have that right. In principle, people should have that right.

36. What (if anything), in terms of health and care dependency, might limit people in exercising such a right? What (if anything), in terms of health and care dependency, might limit people in exercising such a right? What can reasonably be done by Government, to promote it? What can reasonably be done by Government, to promote it?

37. Current Supportive Policies Appropriately designed new build housing Appropriately designed new build housing Housing adaptations Housing adaptations Sheltered Housing Sheltered Housing Housing with Care Housing with Care People First People First Supporting People Supporting People Floating Support Floating Support Community Safety Community Safety

38. Considerations for Policy- makers Real joint planning of Housing and Care budgets – not just aligned policies Real joint planning of Housing and Care budgets – not just aligned policies Ensuring that Government Departments really agree the level of dependency of people who can be maintained at home Ensuring that Government Departments really agree the level of dependency of people who can be maintained at home Planning for population need or responding to market forces Planning for population need or responding to market forces

39. Considerations for Planning Schemes Combination of independence and safety Combination of independence and safety Entry criteria for residents Entry criteria for residents Size of schemes – influence on range of facilities that can be provided Size of schemes – influence on range of facilities that can be provided

40. The importance of location and design features of individual dwellings The importance of location and design features of individual dwellings The housing element of Supported Housing is not a secondary consideration for residents The housing element of Supported Housing is not a secondary consideration for residents Informal support from family and volunteers is integral to functioning Informal support from family and volunteers is integral to functioning

41. Connecting with real experience You are having lunch with a colleague from another organisation who is planning to set up a service incorporating Telehealth/Direct Payments/Supported Housing/Other. Describe an incident or event from your own or others experience or evidence from research with which you are familiar which would illustrate to him/ her what it takes to put this in place in a way which truly promotes independent living for the service users? Have you an example from your experience on how NOT to go about it? The stories/incidents must be real i.e. describing something that actually happened

42. Informing Policy In the light of your earlier conversations and the themes which emerged, what three suggestions should be factored into government policy in regard to: In the light of your earlier conversations and the themes which emerged, what three suggestions should be factored into government policy in regard to: Telehealth/Direct Payments/Supported Housing/Other which would help people live independently with maximum autonomy in the areas which they can exercise control? Have you any further comments or questions for the plenary session? Have you any further comments or questions for the plenary session?

43. Almost there Please complete evaluation forms and return. Please complete evaluation forms and return. Provisional date for next event 20 th March 2008 Provisional date for next event 20 th March 2008 Presentations available on web Presentations available on web Please return name badges for recycling Please return name badges for recycling Lunch and opportunity for networking Lunch and opportunity for networking Thank you for coming! Thank you for coming!

44. Any further comments email to stakeholderengagement@dhsspsni.gov.uk